Chapter 23 and 24 Cancer

Question 1

Benign tumor cells

Answer 1

These cells do not invade, the don’t migrate, and have orderly growth

Question 2

tumor angiogenesis factor (TAF)

Answer 2

When tumor is 1 cm

triggers capillaries and other blood vessels in the area to grow new branches into the tumor

Question 3

Bloodborne metastasis

Answer 3

most common cause of cancer spread

Question 4

Gx

Answer 4

grade can not be determined

Question 5

G1

Answer 5

tumor cells are well differentiated and closely resemble the normal cells from which they arose

Question 6

G2

Answer 6

tumor cells are moderately differentiated- they still retain some of the characteristics of normal cells

Question 7

G3

Answer 7

tumor cells are poorly differentiated and retain no normal cell characteristics

Question 8

Ploidy

Answer 8

the description of cancer cells by chromosome number and appearance. Normal human cells have 46

Question 9

TNM system

Answer 9

Tumor, node, metastasis system describes the anatomic extent of cancers
not useful for leukemia or lymphomas.

Question 10

Tx

Answer 10

Primary tumor cannot be assessed

Question 11

T0

Answer 11

no evidence of primary tumor

Question 12

Tis

Answer 12

carcinoma in situ (in its natural or original place)

Question 13

Nx

Answer 13

regional lymph nodes cannot be assessed

Question 14

N0

Answer 14

no regional lymph node metastasis

Question 15

M0

Answer 15

no distant metastasis

Question 16

M1

Answer 16

distant metastasis

Question 17

Mitotic index

Answer 17

the percentage of actively dividing cells within a tumor

85%- fast growing tumor

Question 18

Viral carcinogens examples

Answer 18

Eptein-Barr virus, hep B and hep C, HPV

Question 19

Biggest CA risk factor

Answer 19

age (>60)

Question 20

7 warning signs of CA

CAUTION

Answer 20

C- changes in bowel or bladder habits
A- A sore throat that does not heal
U- Unusual bleeding or discharge
T- Thickening or lump in the breast or elsewhere
I- Indigestion or difficulty swallowing
O- Obvious change in a wart or mole
N- Nagging cough or hoarseness

Question 21

Cancer that invades the bone marrow causes what?

Answer 21

anemia, thrombocytopenia, and reduce production of healthy WBC’s

Question 22

Cancer that spreads to the liver causes what?

Answer 22

malnutrition and death

Question 23

Radiation tx

Answer 23

destroys cancer cells with minimal exposure to normal cells

local treatment

Question 24

Radiation dose

Answer 24

amount of radiation absorbed by the tissue

always less than exposure

Question 25

Teletherapy

Answer 25

radiation source is external to the PT | PT is not radioactive

Question 26

Brachytherapy

Answer 26

radiation in direct, continuous contact with the tumor | the patient emits radiation and is hazardous to others for 48 hours after

Question 27

Chemotherapy

Answer 27

major tx | has some selectivity for killing CA cells over normal cells

Question 28

Types of normal cells effected by chemotherapy

Answer 28

those that divide rapidly such as skin, hair, intestinal tissues, spermatocytes, and blood forming cells

Question 29

Nadir

Answer 29

the time when bone marrow activity and WBC counts are at their lowest level after chemo

Question 30

Frequency of chemotherapy administration

Answer 30

every 3-4 weeks | on average 4-12 times

Question 31

Extravasation

Answer 31

the major complication of IV infusion drug leaks into the surrounding tissues can cause severe tissue damage Surgery may be needed

Question 32

Side effects of chemo

Answer 32

``` anemia thrombocytopenia neutropenia mucositis changes in cognitive function N/V peripheral neuropathy ```

Question 33

Neutropenia

Answer 33

greatly increases risk for infection and can cause death

Question 34

Neutropenia tx

Answer 34

BMR's (biologic response modifier) to stimulate bone marrow production

Question 35

BMR's ex

Answer 35

neupogen, procrit/epogen, neumega

Question 36

Thrombocytopenia

Answer 36

increases risk for bleeding | <20K platelets may have spontaneous bleeding and need a transfusion

Question 37

Mucositis

Answer 37

open sores on mucous membrane especially stomatitis PT should drink 3L of H2O daily

Question 38

Hormonal manipulation

Answer 38

aimed at decreasing hormones to slow CA growth

Question 39

Tamoxifen

Answer 39

estrogen antagonist-agonist used to tx breast CA binds to estrogen so it is unavailable for cells

Question 40

Tamoxifen se

Answer 40

``` hot flashes and wt gain increased hair growth decreased breast tissue or gynnecomastia in men sexual disfunction increased risk of DVT ```

Question 41

Photodynamic therapy

Answer 41

Selective destruction of cancer cells through a chemical reaction triggered by different types of laser light Dye is administered IV and collects in CA cells in 2-3 days

Question 42

Photodynamic therapy se

Answer 42

photosensitive for 12 weeks (sunblock will not prevent sunburn) eye/skin pain

Question 43

Oncologic Emergencies

Answer 43

``` sepsis disseminated intravascular coagulation (DIC) SIADH spinal cord compression hypercalcemia superior vena cava syndrome ```

Question 44

disseminated intravascular coagulation (DIC)

Answer 44

often caused by sepsis seen in leukemia clotting followed by bleeding

Question 45

disseminated intravascular coagulation (DIC) sx

Answer 45

pain, strokelike symptoms, dyspnea, tachycardia, oilguria, and tissue death

Question 46

SIADH sx and tx

Answer 46

hyponatremia, weakness, muscle cramps, fatigue, loss of appetite, seizures, coma tx: Fluid restrictions

Question 47

Hypercalcemia

Answer 47

usually seen in bone CA

Question 48

Hypercalcemia sx and tx

Answer 48

Fatigue, N/V, constipation, polyuria, etc | tx: Increase hydration, calcitonin

Question 49

Superior vena cava syndrome

Answer 49

Occurs from compression of the SVC

Question 50

Superior vena cava syndrome sx

Answer 50

edema of the face especially around the eyes upon awakening, tightness of the shirt collar, edema in the arms and hands, dyspnea, erythema of the upper body, nose bleeds, ALOC